How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $109.65 | Professional | None | $107.15 | $107.15 | $109.65 |
Christus Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $169.82 Typical High $316.23 | Facility | None | $125.89 | $169.82 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Lucent Health Setting Professional Modifier None Typical Low $660.69 Median $1,096.48 Typical High $1,096.48 | Professional | None | $660.69 | $1,096.48 | $1,096.48 |
Moda Health Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $151.36 | Facility | None | $107.15 | $107.15 | $151.36 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $117.49 | Professional | None | $107.15 | $107.15 | $117.49 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $169.82 Typical High $302.00 | Facility | None | $125.89 | $169.82 | $302.00 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Wellpoint Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
8 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $53.70 Typical High $54.95 | Professional | 52 · Reduced service | $53.70 | $53.70 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $21.88 | Professional | 53 · Discontinued | $21.38 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $16.60 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $10.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $53.70 Typical High $54.95 | Professional | 52 · Reduced service | $53.70 | $53.70 | $54.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $21.88 | Professional | 53 · Discontinued | $21.38 | $21.38 | $21.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $16.60 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $16.60 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $10.96 |
Where Texas sits
The same service costs 4.4 times more in Alaska than in Hawaii. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Texas· 7th of 51
$126
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.